Search

Background/ objective: To evaluate the association of CGM parameters and HbA1c with diabetes complications in patients with Type 1 Diabetes (T1D). Methods: Patients with T1D using the CGM system Freestyle Libre were included in this analysis. The association of CGM-metrics and HbA1c with diabetes complications (any complication, microvascular complications, or macrovascular complications) was assessed using logistic regression unadjusted and adjusted for age, sex, and diabetes duration (model 1), and further adjusted for hypertension and dyslipidemia (model 2). Results: One hundred and sixty-one patients with T1D were included. The mean (± SD) age was 37.4 ± 13.4 years old and the median T1D duration was 17.7 ± 10.6 years. Time in range (TIR) was associated with any complication and microvascular complications in the unadjusted model and in the adjusted models. TIR was associated with retinopathy in the unadjusted model as well as in model 1, and was associated with macrovascular complications only in the unadjusted model. HbA1c was associated with any complications, microvascular complications, and retinopathy in the unadjusted model but not in the adjusted models. HbA1c was associated with macrovascular complications in the unadjusted model and in the adjusted model 1. Conclusions: In this cross-sectional analysis of patients with T1D using intermittent scanned CGM, TIR, and HbA1c were associated with complications of diabetes. TIR may be a better predictor than HbA1c of any complication and microvascular complications, while HbA1c may be a better predictor of macrovascular complications. [ABSTRACT FROM AUTHOR]

How to analyse the omissions of thermal regulations and evaluate methodologies that provide building execution or thermal certificates that do not correspond to reality and usually incur costs? We can start by analysing different simulation methods and shading calculations that provide solar gains and shadow optimisation. After evaluating how the regulations define the calculation assumptions and how this calculation is performed, the discrepancies (simplifications) that the regulations allow or ignore are presented, and it is exemplified using two case studies. Using the Portuguese regulation as a case study, it leads to incorrect conclusions or assumptions due to unequal access to solar radiation or the shading factor calculation that experiences the omission of angles or time periods. Therefore, the aim is to propose a calculation process (premises) that minimises the discrepancies between simulation (optimisation strategy) and reality (applicability of strategies) for sustainable output. [ABSTRACT FROM AUTHOR]

Introduction: The exercise professional's role is to provide proper exercise prescription and selection, regular feedback, positive reinforcement, and behavioral strategies to enhance adherence. Thus, knowing the preferences of the consumers will enhance pedagogical skills. Objective: To characterize pregnant women's preferences regarding the fitness instructor's quality characteristics in specific group exercise sessions for this population. Methods: A qualitative study was conducted in 2021. The Fitness Instructor Quality Questionnaire was applied to 29 pregnant women engaged in prenatal group fitness classes, aged between 24 and 48 years. This questionnaire includes 25 items, grouped in two dimensions, scored with a Likert scale with 7 levels of importance (1 = not at all important; 7 = extremely important). Descriptive statistics were used to characterize pregnant women's opinion (mean, standard deviation, minimum and maximum). Results: The global average of items was 6.41, showing that pregnant women give importance to the Quality of the fitness instructor. Relational Quality has the highest average (6.48), close to Pedagogical-Technical Quality dimension (6.34). The most important items for pregnant women were Ethics (6.76), Communication (6.72), and Availability, Motivation, and Punctuality (6.69). The less important items were Musical Domain (5.24), Image (5.69), and Physical Fitness (5.86). Conclusion: Pregnant women give great importance to the Quality of the fitness instructor, although they value some indicators more than others, as identified in other studies in different populations. Considering the results of this study, it can be recommended that fitness instructors delivering prenatal exercise programs should address these factors related to Quality. It can be emphasized that the fitness instructor should have an intervention that shows willingness to listen to pregnant women, allows them time to perform the exercises, encourages them to practice, without overestimating aspects related to image or fitness level. [ABSTRACT FROM AUTHOR]

Background: Venous obstructions are frequent in patients with transvenous leads, although related clinical findings are rarely reported. After lead replacement or upgrade procedures, these lesions are even more frequent, but there is still no evidence to support this observation. Aim: To investigate the incidence and possible risk factors for upper extremity deep venous thrombosis (UEDVT) and pulmonary embolism (PE) after lead replacement or upgrade procedures. Methods: Prospective cohort carried out between April 2013 and July 2016. Preoperative evaluation included venous ultrasound and pulmonary angiotomography. Diagnostic exams were repeated postoperatively to detect the study outcomes. Multivariate logistic regression models were used to identify prognostic factors. Results: Among the 84 patients included, 44 (52.4%) were female and mean age was 59.3 ± 15.2 years. Lead malfunctioning (75.0%) was the main surgical procedure indication. Lead removal was performed in 44 (52.4%) cases. The rate of postoperative combined events was 32.6%, with 24 (28.6%) cases of UEDVT and six (7.1%) cases of PE. Clinical manifestations of deep venous thrombosis occurred in 10 (11.9%) patients. Independent prognostic factors for UEDVT were severe collateral circulation in the preoperative venography (odds ratio [OR] 4.7; 95% confidence interval [CI] 1.1–19.8; P =.037) and transvenous lead extraction (OR 27.4; 95% CI 5.8–128.8; P <.0001). Conclusion: Reoperations involving previously implanted transvenous leads present high rates of thromboembolic complications. Transvenous lead extraction had a significant impact on the development of UEDVT. These results show the need of further studies to evaluate the role of preventive strategies for this subgroup of patients. [ABSTRACT FROM AUTHOR]

Copyright of Matéria Prima is the property of Revista Meteria Prima and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: Chagas disease (CD) is a frequent cause of dilated cardiomyopathy (CMP) in developing countries, leading to clinical heart failure and worse prognosis. Therefore, the development and evolution of this CMP has always been a major topic in numbers of previous studies. A comprehensive echocardiographic study of left ventricular (LV) mechanics, fully assessing myocardial contraction, has never been done before. This could help characterize and improve the understanding of the evolution of this prevalent CMP.Methods: A total of 47 chagasic and 84 control patients were included in this study and allocated in groups according to LV ejection fraction. 2D-Echocardiogram was acquired for LV mechanics analysis by speckle tracking echocardiography.Results: Mean age of chagasic individuals was 55y and 16 (34 %) were men. Significant difference was found in global longitudinal velocity analysis, with lower values in indeterminate form. In the group with severe systolic dysfunction, a paradoxical increase in longitudinal and apical radial displacements were demonstrated. In parallel, segmental analyzes highlighted lower values of radial displacement, strain and strain rate into inferior and inferolateral walls, with increase of these values in septal and anterior walls.Conclusion: Chagasic CMP has a vicarious pattern of contraction in the course of its evolution, defined by reduced displacement and strain into inferior and posterior walls with paradoxical increase in septal and anterior segments. Also, lower longitudinal velocities were demonstrated in CD indeterminate form, which may indicate an incipient myocardial injury. [ABSTRACT FROM AUTHOR]

Aim: The aim of this study was to determine the influence of gender on chronotropic and hemodynamic response during dobutamine stress echocardiography with early injection of atropine (EA-DSE). Methods: From January 2000 to June 2003, we retrospectively evaluated patients who underwent EA-DSE for known or suspected coronary artery disease. We studied 494 patients, 243 men and 251 women, who were not under beta-blocker or calcium channel-blocker therapy (Group A) and 326 patients, 157 men and 169 women, using these medications (Group B). Differences on chronotropic and hemodynamic responses during EA-DSE were assessed by gender in the two groups. Predictors of need for higher doses of dobutamine were determined by multivariate analysis. Results: In Group A, higher proportion of women achieved test end points at the stage of 20 mcg/kg per minute. Dobutamine and atropine doses were lower in women than in men (29 ± 5 versus 31 ± 6 mcg/kg per minute; P = 0.001 and 0.61 ± 0.32 versus 0.78 ± 0.43 mg; P = 0.006). Cardiac chronotropism and systolic blood pressure response patterns differed by gender. In Group B, there was no difference in the proportion of patients who achieved test end points at each stage of dobutamine. The independent predictors of the need for higher doses of dobutamine in Group A were gender [Odds Ratio (OR) = 1.99, 95% Confidence Interval (CI) = 1.19–3.32; P = 0.008], age (OR = 0.91,CI = 0.89–0.93; P < 0.001), and baseline heart rate (OR = 0.95,CI = 0.93–0.98; P < 0.001). Independent predictors in the total population were age (OR = 0.92,CI = 0.90–0.94; P < 0.001), baseline heart rate (OR = 0.95,CI = 0.93–0.97; P < 0.001), and beta-blocker therapy (OR = 0.42,CI = 0.18–1.51; P = 0.04). Conclusion: Gender has influence on heart rate and blood pressure response to the EA-DSE in patients without use of drugs with negative chronotropic effects. [ABSTRACT FROM AUTHOR]

In the following study, three different dairy by-products, previously concentrated by ultrafiltration (UF), were used as ingredients in the production of reduced-fat (RF) washed curd cheeses in order to improve their characteristics. Conventional full-fat (FF) cheeses (45% fat, dry basis (db)) and RF cheeses (20–30% fat, db) were compared to RF cheeses produced with the incorporation of 5% concentrated whey (RF + CW), buttermilk (RF + CB) or sheep second cheese whey (RF + CS). Protein-to-fat ratios were lower than 1 in the FF cheeses, while RF cheeses ranged from 1.8 to 2.8. The tested by-products performed differently when added to the milk used for cheese production. The FF cheese showed a more pronounced yellow colour after 60 and 90 days of ripening, indicating that fat plays an important role regarding this parameter. As far as the texture parameters are concerned, after 60 days of ripening, RF cheeses with buttermilk presented similar results to FF cheeses for hardness (5.0–7.5 N) and chewiness (ca. 400). These were lower than the ones recorded for RF cheeses with added UF concentrated whey (RF + CW) and second cheese whey (RF + CS), which presented lower adhesiveness values. RF cheeses with 5% incorporation of buttermilk concentrated by UF presented the best results concerning both texture and sensory evaluation. [ABSTRACT FROM AUTHOR]